How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $128.82 | Facility | None | $54.95 | $64.57 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $95.50 | Professional | None | $54.95 | $64.57 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $91.20 | Professional | None | $64.57 | $85.11 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | None | $70.79 | $83.18 | $93.33 |
CDPHP Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | None | $104.71 | $104.71 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $141.25 | Professional | None | $56.23 | $69.18 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $66.07 Typical High $181.97 | Facility | None | $0.10 | $66.07 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | None | $89.13 | $104.71 | $144.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $102.33 | Professional | None | $40.74 | $83.18 | $102.33 |
Highmark BCBS Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | None | $117.49 | $117.49 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | None | $60.26 | $60.26 | $120.23 |
United Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $109.65 | Professional | None | $54.95 | $77.62 | $109.65 |
Univera Setting Facility Modifier None Typical Low $39.81 Median $66.07 Typical High $338.84 | Facility | None | $39.81 | $66.07 | $338.84 |
Univera Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $100.00 | Professional | None | $40.74 | $83.18 | $100.00 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $27.54 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.55 Typical High $11.75 | Professional | 55 · Aftercare only | $8.32 | $9.55 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.62 | $6.46 | $7.76 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | HG · Opioid treatment program | $89.13 | $89.13 | $89.13 |
Where New York sits
The same service costs 2.9 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 40th of 51
$77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.